Kelly Smidebush, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP9279024 Issued in FL

Practice address

129 E Redstone Ave
Suite a
Crestview, FL 32539-5350

Phone

(850) 682-7212

Fax

(850) 682-6302

NPI assigned

Sep 10, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emerald Coast Heart and Afib PLLCGroup PAC ID 3072041987, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Fort Walton-Destin Hospital Hospital, Fort Walton Beach, FL, CCN 100223
• North Okaloosa Medical Center Hospital, Crestview, FL, CCN 100122

Merit-based Incentive Payment System (MIPS)

Final score

82.55 of 100Reported as group

Quality

68.18

Improvement activities

40

Cost

78.15

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/0009543
• Direct secure messaging: kellysmidebush@ocfl.allscriptsdirect.net
• Direct secure messaging: kelly.smidebush@859661945733124.direct.elationemr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Emerald Coast Heart & Afib, PLLC

  • Clinical Cardiac Electrophysiology Physician
  • Crestview, FL
  • NPI 1578388229
  Medicare reassignment Care Compare group NPD
• Okaloosa Cardiology P a

  • Cardiovascular Disease Physician
  • Crestview, FL
  • NPI 1144270240
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Crestview Hospital Company, LLC

  • General Acute Care Hospital
  • Crestview, FL
  • NPI 1104897859
  Care Compare affiliation
• Fort Walton Beach Medical Center, Inc.

  • General Acute Care Hospital
  • Ft Walton Beach, FL
  • NPI 1639128820
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1104176833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 E REDSTONE AVE",
            "address_2": "SUITE A",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325395350",
            "telephone_number": "850-682-7212",
            "fax_number": "850-682-6302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 E REDSTONE AVE",
            "address_2": "SUITE A",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325395350",
            "telephone_number": "850-682-7212",
            "fax_number": "850-682-6302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMIDEBUSH",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-10",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9279024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zaria Singleton-Ledet
• Siwicki & Ricciardi,P.L.
• Alyssa Slattery, WHNP-BC
• Jared Steven Sleeman, IDMT
• Sarah Slimski
• Alexa Smith, RBT
• Denise Anne Smith, M.D., PH.D.
• Jonathan Edward Smith
• Kristina Smith, APRN
• Marilyn Ruth Smith, NP-C APRN

• Nurse Practitioner in Crestview, FL
• Providers in Crestview, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.